Swine flu (H1N1) reached pandemic proportions in 2009, yet ambivalence was met concerning intentions to be vaccinated. The present investigation determined predictors of perceived H1N1 contraction risk and vaccination intentions among Canadian adults (N = 1,027) responding to an online questionnaire. The relatively low rate of vaccination intent (30.12%, and 34.99% being unsure of their intent) was related to a sense of invulnerability regarding illness contraction and symptom severity. Most individuals were skeptical that H1N1 would be widespread, believing that less than 10% of the population would contract H1N1. Yet, they also indicated that their attitudes would change once a single person they knew contracted the illness. Also, worry regarding H1N1 was related to self-contraction risk and odds of individuals seeking vaccination. Moreover, vaccination intent was related to the perception that the threat was not particularly great, mistrust of the media to provide accurate information regarding H1N1, and whether individuals endorsed problem-focused versus avoidant coping strategies. Given the role media plays in public perceptions related to a health crisis, trust in this outlet and credibility regarding the threat are necessary for adherence to recommended measures to minimize health risk.
To retrospectively examine the barriers faced and opportunities for improvement during the 2009 H1N1 pandemic response experienced by participants responsible for the delivery of health care services in 3 remote and isolated Subarctic First Nation communities of northern Ontario, Canada.
A qualitative community-based participatory approach.
Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the 3 main sectors responsible for health care services (i.e., federal health centres, provincial hospitals and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis.
Primary barriers reported were issues with overcrowding in houses, insufficient human resources and inadequate community awareness. Main areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies and general community awareness regarding disease processes and prevention.
Government bodies should consider focusing efforts to provide more support in terms of human resources, monies and education. In addition, various government organizations should collaborate to improve housing conditions and timely access to resources. These recommendations should be addressed in future pandemic plans, so that remote western James Bay First Nation communities of Subarctic Ontario and other similar communities can be better prepared for the next public health emergency.
The aim of the present study was to investigate how the initial phase of the COVID-19 pandemic affected the hospital stroke management and research in Norway.
All neurological departments with a Stroke Unit in Norway (n = 17) were invited to participate in a questionnaire survey. The study focused on the first lockdown period, and all questions were thus answered in regard to the period between 12 March and 15 April 2020.
The responder rate was 94% (16/17). Eighty-one % (13/16) reported that the pandemic affected their department, and 63% (10/16) changed their stroke care pathways. The number of new acute admissions in terms of both strokes and stroke mimics decreased at all 16 departments. Fewer patients received thrombolysis and endovascular treatment, and multidisciplinary stroke rehabilitation services were less available. The mandatory 3 months of follow-up of stroke patients was postponed at 73% of the hospitals. All departments conducting stroke research reported a stop in ongoing projects.
In Norway, hospital-based stroke care and research were impacted during the initial phase of the COVID-19 pandemic, with likely repercussions for patient care and outcomes. In the future, stroke departments will require contingency plans in order to protect the entire stroke treatment chain.
Since the time of global SARS-CoV-2 spread across the earth in February 2020, most of countries faced the problem of massive stress of their healthcare systems. In many cases, the structural stress was a result of incorrect allocation of medical care resources. In turn, this misallocation resulted from fear and apprehensions that superseded thorough calculations. A key role in exacerbating the healthcare sector overburdening was played by misleading information on the virus and disease caused by it. In the current paper, we study the situation in Russian healthcare system and advance recommendations how to avoid further crises.
(a) Surveying the medical personnel (231 doctors, 317 nurses and 355 ambulance medical workers of lower levels) in five hospitals and six ambulance centres in Moscow. (b) Content analysis of 3164 accounts in Russian segment of social networks (VKontakte, Facebook, Instagram, Twitter, Odnoklassniki); official and unofficial media (TV, informational webpages).
We revealed positive-feedback loop that threatened the sustainability of Russian care sector. The main knot was occupied by incorrect/exaggerated media coverage of COVID-19. General public scared by misinformation in media and social networks, started to panic. This negative social background undermined the productivity of a significant part of medical workers who were afraid of COVID-19 patients.
The most serious problems of Russian healthcare sector related to COVID-19 pandemic, were informational problems. The exaggerated information on COVID-19 had big negative influence upon Russian society and healthcare system, despite SARS-CoV-2 relatively low epidemiological hazard.
Narcolepsy is a lifelong sleep disorder related to hypocretin deficiency resulting from a specific loss of hypocretin-producing neurons in the lateral hypothalamic area. The disease is thought to be autoimmune due to a strong association with HLA-DQB1*06:02. In 2009 the World Health Organization (WHO) declared the H1N1 2009 flu pandemic (A/H1N1PDM09). In response to this, the Swedish vaccination campaign began in October of the same year, using the influenza vaccine Pandemrix(?). A few months later an excess of narcolepsy cases was observed. It is still unclear to what extent the vaccination campaign affected humoral autoimmunity associated with narcolepsy. We studied 47 patients with narcolepsy (6-69 years of age) and 80 healthy controls (3-61 years of age) selected after the Pandemrix vaccination campaign. The first aim was to determine antibodies against A/H1N1 and autoantibodies to Tribbles homolog 2 (TRIB2), a narcolepsy autoantigen candidate as well as to GAD65 and IA-2 as disease specificity controls. The second aim was to test if levels and frequencies of these antibodies and autoantibodies were associated with HLA-DQB1*06:02. In?vitro transcribed and translated [(35)S]-methionine and -cysteine-labeled influenza A virus (A/California/04/2009/(H1N1)) segment 4 hemagglutinin was used to detect antibodies in a radiobinding assay. Autoantibodies to TRIB2, GAD65 and IA-2 were similarly detected in standard radiobinding assays. The narcolepsy patients had higher median levels of A/H1N1 antibodies than the controls (p?=?0.006). A/H1N1 antibody levels were higher among the
Texas Children's Center for Vaccine Development, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA; Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A&M University, College Station, TX, USA. Electronic address: email@example.com.
The last five years has seen a sharp rise in anti-science rhetoric in the United States, especially from the political far right, mostly focused on vaccines and, of late, anti-COVID-19 prevention approaches. Vaccine coverage has declined in more than 100 US counties leading to measles outbreaks in 2019, while in 2020 the US became the epicenter of the COVID-19 pandemic. Now the anti-science movement in America has begun to globalize, with new and unexpected associations with extremist groups and the potential for tragic consequences in terms of global public health. A new anti-science triumvirate has emerged, comprised of far right groups in the US and Germany, and amplified by Russian media.
This study sought to contribute to the existing literature on pandemic influenza vaccination studies by providing additional evidences of households' willingness to pay (WTP) for protection against influenza during a pandemic situation from North America.
A standard dichotomous-choice contingent valuation survey was designed and completed in a sample of 306 individuals living in the Greater Toronto Area, Ontario, Canada.
This study shows that, on average, households are willing to pay $417.35 for immediate pandemic influenza (H1N1) vaccination. Results show that the vaccine price, age, gender, occupation, organisation, annual family income, receiving annual flu shot, having additional insurance, having someone with a serious illness in the house, knowledge about pandemics, trusting official information on pandemics, supporting government expenditure, and rating government pandemic planning have significant effects on the decision to accept the vaccine bids.
The results reconfirm the findings of similar studies that influenza vaccine programmes are highly cost-effective despite the high programme cost, because people's WTP (benefits) for this programme is much higher than the actual costs. Pandemic influenza vaccination programmes should consider the demographic and economic status of the target population as such characteristics have significant impacts on the benefits that people place on such programmes.
Assessing the effectiveness and feasibility of implementing mitigation measures for an influenza pandemic in remote and isolated First Nations communities: a qualitative community-based participatory research approach.
The next influenza pandemic is predicted to disproportionately impact marginalized populations, such as those living in geographically remote Aboriginal communities, and there remains a paucity of scientific literature regarding effective and feasible community mitigation strategies. In Canada, current pandemic plans may not have been developed with adequate First Nations consultation and recommended measures may not be effective in remote and isolated First Nations communities.
This study employed a community-based participatory research approach. Retrospective opinions were elicited via interview questionnaires with adult key healthcare informants (n=9) regarding the effectiveness and feasibility of implementing 41 interventions to mitigate an influenza pandemic in remote and isolated First Nations communities of sub-Arctic Ontario, Canada. Qualitative data were manually transcribed and deductively coded following a template organizing approach.
The results indicated that most mitigation measures could potentially be effective if modified to address the unique characteristics of these communities. Participants also offered innovative alternatives to mitigation measures that were community-specific and culturally sensitive. Mitigation measures were generally considered to be effective if the measure could aid in decreasing virus transmission, protecting their immunocompromised population, and increasing community awareness about influenza pandemics. Participants reported that lack of resources (eg supplies, monies, trained personnel), poor community awareness, overcrowding in homes, and inadequate healthcare infrastructure presented barriers to the implementation of mitigation measures.
This study highlights the importance of engaging local key informants in pandemic planning in order to gain valuable community-specific insight regarding the design and implementation of more effective and feasible mitigation strategies. As it is ethically important to address the needs of marginalized populations, it is recommended that these findings be incorporated in future pandemic plans to improve the response capacity and health outcomes of remote and isolated First Nations communities during the next public health emergency.
Several studies investigating potential adverse effects of the pandemic A(H1N1) vaccine have supported that influenza A(H1N1) vaccination does not increase the risk for major pregnancy and birth adverse outcomes, but little is known about possible adverse effects in offspring of A(H1N1)-vaccinated mothers beyond the perinatal period and into early childhood.
To evaluate whether pandemic influenza A(H1N1) vaccination in pregnancy increases the risk for early childhood morbidity in offspring.
Register-based cohort study comprising all live-born singleton children in Denmark from pregnancies overlapping the A(H1N1) influenza vaccination campaign in Denmark, from November 2, 2009, to March 31, 2010. From a cohort of 61?359 pregnancies, offspring exposed and unexposed to the influenza A(H1N1) vaccine during pregnancy were matched 1:4 on propensity scores.
Vaccination in pregnancy with a monovalent inactivated AS03-adjuvanted split virion influenza A(H1N1)pdm09 vaccine (Pandemrix; GlaxoSmithKline Biologicals).
Rate ratios of hospitalization in early childhood until 5 years of age. Hospitalization was defined as (1) first inpatient hospital admission, (2) all inpatient hospital admissions, and (3) first hospital contact for selected diseases, which included individual infectious diseases and individual neurologic, autoimmune, and behavioral conditions.
The mean (SD) age at end of follow-up was 4.6 (0.40) years for the 61?359 children included in the study. In the cohort, the mothers of 55?048 children were unvaccinated, 349 mothers were vaccinated in the first trimester, and 5962 mothers were vaccinated in the second or third trimesters. Children exposed in the first trimester were not more likely to be hospitalized in early childhood than unexposed children (hospitalization rates per 1000 person-years, 300.6 for exposed vs 257.5 for unexposed; rate ratio, 1.17; 95% CI, 0.94-1.45). Similarly, children exposed in the second or third trimester were not more likely to be hospitalized in early childhood than unexposed children (hospitalization rates per 1000 person-years, 203.6 for exposed vs 219.3 for unexposed; rate ratio, 0.93; 95% CI, 0.87-0.99). This 7% decreased risk was primarily a result of reduced risks for infectious disease-related hospitalizations.
To our knowledge, this is the most comprehensive study to date of potential adverse effects manifesting after the perinatal period. We detected no increased risk for early childhood morbidity. These results support the safety profile of the influenza A(H1N1) vaccine used in pregnancy.
Prior to the 2009 H1N1 Influenza pandemic, public health authorities in Canada and elsewhere prepared for the future outbreak, partly guided by an ethical framework developed within the Canadian Program of Research on Ethics in a Pandemic (CanPREP). We developed a telephone-based survey based on that framework, which was delivered across Canada in late 2008. In June, 2009, the WHO declared pandemic Phase 6 status and from the subsequent October (2009) until May 2010, the CanPREP team fielded a second (revised) survey, collecting another 1,000 opinions from Canadians during a period of pre-pandemic anticipation and peri-pandemic experience.
Surveys were administered by telephone with random sampling achieved via random digit dialing. Eligible participants were adults, 18 years or older, with per province stratification approximating provincial percentages of national population. Descriptive results were tabulated and logistic regression analyses used to assess whether demographic factors were significantly associated with outcomes, and to identify divergences (between the pre-pandemic and intra-pandemic surveys).
N = 1,029 interviews were completed from 1,986 households, yielding a gross response rate of 52% (AAPOR Standard Definition 3). Over 90% of subjects indicated the most important goal of pandemic influenza preparations was saving lives, with 41% indicating that saving lives solely in Canada was the highest priority and 50% indicating saving lives globally was the highest priority. About 90% of respondents supported the obligation of health care workers to report to work and face influenza pandemic risks excepting those with serious health conditions which that increased risks. Strong majorities favoured stocking adequate protective antiviral dosages for all Canadians (92%) and, if effective, influenza vaccinations (95%). Over 70% agreed Canada should provide international assistance to poorer countries for pandemic preparation, even if resources for Canadians were reduced.
Results suggest Canadians trust public health officials to make difficult decisions, providing emphasis is maintained on reciprocity and respect for individual rights. Canadians also support international obligations to help poorer countries and associated efforts to save lives outside the country, even if intra-national efforts are reduced.
Cites: N Engl J Med. 2009 Jun 18;360(25):2605-1519423869